As a skin care therapist you need to get your clients skin to be the most radiant skin possible. Healthy skin is well hydrated, and yet if we look around us then we will see that a significant number of people have got dry dull skin. They try and hide this with make-up. The ideal is to achieve skin that is lovely and needs minimal make-up.

How can we achieve this?

Throughout the year we are all faced with different atmospheric conditions, and even conflicting domestic and work environments. In many people this can upset the natural moisture levels in our skin and result in dry skin. Holidays in drier climates may aggravate this condition and present quite a problem to the skin care therapist.

Seasonal changes in the skin are normal and more noticeable when the weather turns cold. For as yet unexplained reasons, there is a reduction in the natural moisturising factors of the skin in winter. These changes are worse in women than in men, and moreover the changes are greater as one ages. The skin becomes dry because of changes that occur in the natural ceramides and keratins of the skin. Unfortunately, you cant correct the problem by simply rubbing on a cream containing ceramides or keratin.

Another important point to bear in mind is that hormonal changes in women as they age are reflected by thinner and drier skin. This is due to a relative deficiency of oestrogen and or progesterone. You may notice this developing in a client who previously may never have suffered from dry skin. On the other hand, women who start off with dry skin get progressively worse as they get older. Hormone supplementation is essential and the client should be referred to her general practitioner or gynaecologist for treatment. Simple cosmetics will never be enough!

Chronic sun damage, particularly in men, often manifests as dry, ruddy, fragile skin which is generally uncomfortable, and sensitive when shaving. One has to recognize that the problem here is a chronic deficiency of the fundamental light-sensitive vitamins, the most notable of which is vitamin A. However, people with this type of skin need special care from the skin care therapist because simple application of vitamin A products will aggravate the problem.

The situation is aggravated further because vitamin A is one of the most powerful stimulants for Hyaluronic acid in the dermis.
Hyaluronic acid is one of the glycoseaminoglycans that have the ability to attract water and plump out the skin.

As we get older, we make less and less hyaluronic acid because, of course we suffer a progressively worse and worse localised vitamin A deficiency in the sun-exposed areas of our skin.

This deterioration can eventually cause dermatoporosis on account of the virtual depletion of hyaluronic acid in the dermis. The next best thing after vitamin A for stimulating natural hyaluronic acid is medium chain length versions of hyaluronic acid. Both vitamin A and medium chain length hyaluronic acid stimulate the CD44 receptor which results in the production of more hyaluronic acid. The more hyaluronic acid in the skin, the greater the natural moisturisation of the skin. Unfortunately, you cannot rub on hyaluronic acid because it is too large a molecule to penetrate through skin. The only way is to use fine (cosmetic) skin needling with needles of 0.1 to 0.2 mm in length to make holes in the stratum corneum that is the barrier to penetration. That way the applied hyaluronic acid can easily penetrate into the areas where it is needed and restore natural moisture. The alternative ways to facilitate penetration are iontophoresis and low frequency sonophoresis.

Of course the fundamental change in all dry skin conditions, is that the stratum corneum (the horny layer) is no longer an effective waterproofing barrier. As skin care therapists we have to recognise that the manifestation of the problem lies at the surface of the skin at the lower level of the stratum corneum, but the actual problem is most likely due to abnormal basal cell (keratinocyte) function.

A healthy keratinocyte will manufacture various keratins and ceramides as it migrates up towards the surface of the skin. In the final stages of dying, the cells will extrude those special molecules that will create the normal effective waterproofing barrier called the lipid bi layers. The cells by then are flattened and dehydrated naturally and create the multi-layered horny layer, which is our most important defence against the environment.

You need to remind your client that this dead layer is absolutely normal and desirable and that they should not try and remove it, especially if there are dry scales on the surface. The average person on the street does not understand that the skin is the only organ of our body that fulfils its function by dying.

What can we do to treat dry skin?

First of all look at the clients daily regime.

Change the way your client cleanses the skin. Remind them that the stratum corneum is an extremely delicate layer that is less than 0.02 mm thick so it is easily damaged by harsh soaps and vigorous cleansing techniques. Skin should be gently cleaned without damaging that uppermost horny layer of the skin. Soaps and abrasives easily destroy this layer that is so essential to maintain the waterproofing barrier of the skin. Uses a mild non-soap slightly acidic cleanser and avoid soapy foaming cleansers. If you use make-up then at night before going to sleep, remove all the make-up. On the other hand, in the morning you will only need to wash the skin with water and a finger massage. That is the safest way to preserve your natural barrier.

If your client has a delicate skin then a toner may not be necessary until normal hydration has been achieved. Tone skin with a mild AHA toner. Glycolic or preferable lactic acid in low doses, at the right pH, can promote moisture in the skin. In more severe dry skin consider using a product with sodium or ammonium lactate. This will not only smooth the skin beautifully, but also make the skin more comfortable and boost natural moisturising factors. Lactates are also inhibitors of pigment production, so this may have value for those with pigmentation problems as well.

Start preparing dry skin for the winter by using low dose vitamin A many months ahead. Some people with dry skin find that vitamin A products aggravate their dry skin. Advise them to use the vitamin A cream only every second day if their skin is very dry. In some cases I have even suggested that the client applies the vitamin A cream for only an hour and then washes it off. Slowly increase the frequency of application until it is being used both day and night every day. This dryness is, fortunately, transient because vitamin A is one of the most potent stimulators of hyaluronic acid, a natural moisturising factor.

Vitamin A will stimulate the production of better ceramides and keratins and also increase the production of glycosaminoglycans, which enrich the intra-cellular space with water. Use additional products rich in humectants and fatty acids that are essential for skin moisture. Olive oil (oleic acid) is very useful.

Topical hyaluronic acid gels can be used but only if the client is also using a micro-needling system with needles protruding only 0.1 to 0.2 mm to enable delivery of the hyaluronic acid to the area that needs it.

In the worst scenario, people with dry skin may have to resort to using Vaseline (use a good grade from a reputable company). The oily surface blocks loss of water through the skin and thereby improves moisture levels of the skin. Some people find relief by using this periodically at night. Apply the Vaseline on top of the vitamin A cream for best results. This regime should only be used for a limited period in people with a disrupted or deficient horny layer. Stop as soon as the horny layer is re-established even though the skin may still feel dry.

In women from about 35 onwards who are starting to feel dry skin, consider using a topical oestrogen or progesterone cream. Get the advice of their doctor who can write out a prescription. Oestriol is a form of oestrogen that is reputedly the best for topical applications, because it is not absorbed in the bloodstream.

Sometimes you may encounter the paradox of dry skin in people with oily skin or acne prone skin. Generally the problem is due to excessive washing of the skin and the best way to treat these people is to advise them to stop washing their face with soap. They hate that advice and believe that their skin will break out in acne. Their cleansers should contain ingredients that disperse oil, and they should start using vitamin A based products to reduce the amount of sebum secretion.

People with dry skin should AVOID:

Excessive sun exposure, which aggravates dry skin.

Heated rooms without increasing the moisture levels

Air conditioned environments aggravate the problem

High doses of Vitamin A creams until the skin has acclimatised to Vitamin A

High does of AHA products-they may initially relieve dry skin, but then with persistent use may aggravate the problem

Skin Peeling this will only aggravate the problem

Saunas, they dehydrate the skin. Rather use a steam room.

Fat free diets and take EFA's

Salon Treatments:

Consider using a lactic acid preparation with a higher pH in conjunction with iontophoresis. Iontophoresis should be done on negative polarity. The lactate moiety of lactic acid is propelled into the depth of the skin and this is responsible for improved natural moisturisation factors. The moisture barrier of the skin is also strengthened.

Iontophoresis of a low dose vitamin A gel may rapidly help to restore a normal horny layer.

Apply an occlusive alginate mask for 10 to 15 minutes and allow the moisture levels in the skin to build up.

By using these simple steps you can expect to restore normal hydration to the skin within four to six weeks.

In those of your clients who have a ruddy complexion, the addition of vitamin C as an added major treatment at home and also in the salon will help to reduce the appearance of broken capillaries and restore a normal colour to the skin as well as normal hydration.
By concentrating on restoring and maintaining optimum thickness of the dead cells that comprise the horny layer you will make the skin look healthier, feel more comfortable and reduce the dependency on make-up to enhance the skin.

This article was supplied by Dr Des Fernandes
Founder & Creator of Environ
For more information about Environ please click HERE.

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